Strokes in Young People: Are the Numbers Really on the Rise?

Strokes in Young People: Are the Numbers Really on the Rise?

Age is a major factor for having a stroke, but older people aren't the only ones at risk.

Age is a major risk factor for having a stroke—in fact, the risk of stroke doubles each decade after age 55. But a study published in the Journal of the American Heart Association in May 2016 found that while hospitalizations for ischemic strokes (those caused by a clot) overall dropped 18.4 percent between 2000 and 2010, hospitalizations for ischemic strokes in people between the ages of 25 and 44 have risen by 44 percent.

An April 2017 study published in JAMA Neurology backs this up. Ischemic stroke hospitalizations between 2003 and 2012 rose by 41.5 percent for men between the ages of 35 and 44 and 30 percent for women in the same age range.

Is there an epidemic of ischemic stroke striking the young and middle-aged? Not exactly, says Noor Sachdev, MD, a neurologist with Good Samaritan Hospital in San Jose, California. “I don’t think anything has changed dramatically,” he says. So why the big jump in strokes in younger people? Read on for Dr. Sachdev’s take and to learn what you can do to reduce your risk of having a stroke.

Better education and diagnosis
Sachdev believes better diagnosis contributed to the 44 percent increase, both on the patient side and the doctor side. “Younger people know more about the symptoms of stroke so they are coming into the hospital sooner and seeking treatment,” he says. “Our capabilities of diagnostic testing are better." Younger people may not suddenly be having more strokes, but we’re seeing that people are more educated about it, Sachdev says.

Groups like the American Heart Association and the American Stroke Association have worked hard to educate people about strokes, says Sachdev. Younger people may also have parents who have experienced stroke, so they could be familiar with stroke symptoms and effects. “Plus, they have the Internet. If they have a symptom they can look it up,” he says.

If you think you or someone else is having a stroke, call 911 as soon as possible. First responders are now trained in identifying stroke patients and quickly taking them to stroke centers for treatment. CT scans are the first step in diagnosing stroke. A CT scan can determine whether there is bleeding in the brain (hemorrhagic stroke) or if the stroke was a result of a clot.

The treatment approach depends on the results of the CT scan. Further testing such as MRIs, CT angiograms and perfusion studies, ultrasounds or cerebral angiograms also help to diagnose a stroke and its cause. “The technology is getting better. There is now software that can analyze cerebral blood flow, which can tell us if there’s a clot, what area of the brain is lacking blood flow and if there’s tissue that can be salvaged,” says Sachdev.

Causes of and recovery from strokes in young people
The seeming increase in strokes in young people could be due to diagnostic advances and education, but the root causes of stroke are likely to be different in younger patients. “The differential for stroke in young people is really broad,” says Sachdev. While atherosclerosis is the most common cause of stroke overall, other artery problems like vasculitis, heart abnormalities, dissection (vessel tear) and blood clots are the most common reasons for strokes in younger patients.

Recovery often differs in younger patients too, and that’s the good news, says Sachdev. “Younger patients, just by the nature of the brain itself, will heal faster no matter what you do,” he says. “You don’t get brain tissue back, but you have neuroplasticity, a constant rewiring and re-networking of the brain.” Younger people may also heal faster because they’re generally stronger, have fewer other diseases and can better tolerate the sometimes-grueling physical therapy that doctors recommend, says Sachdev.

Preventing a stroke
Whether you’re 25 or 75, there are steps you can take to prevent a stroke. “We’ve gotten better in terms of medication, but lifestyle is key,” says Sachdev. “The number one risk factor is a previous stroke." Hypertension, diabetes, high cholesterol, smoking and obesity follow close behind.

You can start to lower your risk by making changes to your daily habits. “Just by meeting basic government recommendations on exercise,” says Sachdev, “you can increase your life expectancy by seven years.” The Centers for Disease Control and Prevention recommends people get at least 150 minutes per week of moderate aerobic exercise or 75 minutes per week of vigorous aerobic exercise.

According to a study published in July 2016 in The Lancet, there are 10 risk factors responsible for about 90 percent of all strokes worldwide—many of which can be reduced by making the right lifestyle changes. The authors wrote that high blood pressure is the most important modifiable risk factor. Other risk factors in the study include:

  • Smoking
  • Waist-to-hip ratio
  • Diet
  • Physical activity
  • Drinking alcohol
  • Diabetes

The good news: all of these risk factors can be influenced in some degree by your choices and habits.

“Things happen in life that you can’t control, but you can control your health,” says Sachdev. “The culture of medicine is changing with the patient taking more responsibility for their health rather than just coming to the doctor to be fixed. There’s enough knowledge out there that shows how critical lifestyle modification is to overall health and well-being.”

This article was updated on April 26, 2018